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Purpose <p>This study aimed to evaluate the feasibility and outcomes of curative-intent surgery in patients with clinically node-positive non-small cell lung cancer (NCSLC) and interstitial lung disease (ILD).</p> Methods <p>We retrospectively evaluated patients with clinically node-positive NSCLC and ILD, who underwent curative-intent surgery between 2012 and 2022. Survival outcomes and complications were also assessed. Risk stratification for acute exacerbations of ILD (AE-ILD) was performed using the Japanese Association for Chest Surgery (JACS) score.</p> Results <p>Twenty-eight patients were included in the study. Postoperative AE-ILD developed in 17.9% of patients within 30&#xa0;days and 25.0% within 90&#xa0;days. The incidence was lower in the low-risk group than in the intermediate-risk group (30&#xa0;days: 12.5 vs. 20.0%; 90&#xa0;days: 12.5 vs. 30.0%). No ILD-related deaths occurred within one year postoperatively in the low-risk group, whereas 71.4% of the deaths in the intermediate-risk group were ILD-related. The median overall survival (OS) and recurrence-free survival (RFS) were 19.5 and 13.7&#xa0;months, respectively. Patients with cN1 or cN2a had favorable outcomes (OS: 28.5 and 28.6&#xa0;months; RFS: 13.7 and 28.6&#xa0;months, respectively), whereas those with cN2b showed poor survival (OS/RFS: 2.4&#xa0;months).</p> Conclusions <p>Curative-intent surgery may offer survival benefits for selected patients, particularly those with limited nodal disease and a low risk of AE-ILD.</p>

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Feasibility and outcomes of curative-intent surgery for clinically node-positive non-small cell lung cancer with interstitial lung disease

  • 期刊论文

  • 发表日期：

    2025年10月15日

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  • Masatoshi Kanayama,
  • Manabu Yasuda,
  • Toshihiro Osaki,
  • Hina Jojiki,
  • Natsumasa Nishizawa,
  • Yasuhiro Chikaishi,
  • Fumihiro Tanaka

摘要

Purpose

This study aimed to evaluate the feasibility and outcomes of curative-intent surgery in patients with clinically node-positive non-small cell lung cancer (NCSLC) and interstitial lung disease (ILD).

Methods

We retrospectively evaluated patients with clinically node-positive NSCLC and ILD, who underwent curative-intent surgery between 2012 and 2022. Survival outcomes and complications were also assessed. Risk stratification for acute exacerbations of ILD (AE-ILD) was performed using the Japanese Association for Chest Surgery (JACS) score.

Results

Twenty-eight patients were included in the study. Postoperative AE-ILD developed in 17.9% of patients within 30 days and 25.0% within 90 days. The incidence was lower in the low-risk group than in the intermediate-risk group (30 days: 12.5 vs. 20.0%; 90 days: 12.5 vs. 30.0%). No ILD-related deaths occurred within one year postoperatively in the low-risk group, whereas 71.4% of the deaths in the intermediate-risk group were ILD-related. The median overall survival (OS) and recurrence-free survival (RFS) were 19.5 and 13.7 months, respectively. Patients with cN1 or cN2a had favorable outcomes (OS: 28.5 and 28.6 months; RFS: 13.7 and 28.6 months, respectively), whereas those with cN2b showed poor survival (OS/RFS: 2.4 months).

Conclusions

Curative-intent surgery may offer survival benefits for selected patients, particularly those with limited nodal disease and a low risk of AE-ILD.